Medicare Coverage Expanded for Weight-Loss Drug Wegovy in Cardiovascular Patients

The expanded FDA approval is based on a Kaiser Family Foundation study which found that approximately one-quarter of Medicare patients have both heart disease and obesity, making them potential candidates for Wegovy coverage. While Medicare Part D plans do not typically cover obesity medications, the new approval allows for coverage when the drug is prescribed to mitigate cardiovascular risks in overweight or obese individuals. Several Medicare D plans are already providing coverage for Wegovy in heart patients, with broader coverage expected by 2025. It is estimated that 1.9 million of the 3.6 million newly eligible Medicare patients are also diabetic, qualifying them for coverage of Novo Nordisk’s Ozempic, which contains the same active ingredient, semaglutide, as Wegovy. The main competitor to Wegovy and Ozempic is Eli Lilly’s tirzepatide, marketed as Mounjaro for diabetes and Zepbound for weight-loss. Novo Nordisk remains a preferred investment option, despite a recent moderate pullback. The company holds a strong competitive position in the obesity treatment market, with GLP-1 agonists playing a significant role in shaping the future of obesity management.

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